Peadiatric ENT Surgery

Question 1

what is important to get from a history?

Answer 1

> the birth history: preterm, traumatic birth, neonatal jaundice
breast fed or bottle fed
passive smoking
speech development

Question 2

what groups are at risk?

Answer 2

> strong family history
meningitis
perinatal sepsis

Question 3

what tests are used to assess hearing at birth?

Answer 3

> automated optoacoustic emission

> automated auditory brainstem response

Question 4

what test could you use to test a 6-18 month olds hearing?

Answer 4

a distraction test

Question 5

how would you test a 12 month to 3 year olds hearing?

Answer 5

visually reinforced audiometry

Question 6

what test would you use to check the hearing of a 3-5 year old?

Answer 6

play audiometry

Question 7

at what age could you use a pure tone audiometry to check hearing?

Answer 7

4+

Question 8

what does the tympanometer create?

Answer 8

a change in pressure in the ear canal

Question 9

what groups are at risk pf otitis media with effusion?

Answer 9

> day care
> older siblings
> parental smoking
> cleft palate
> downs syndrome

Question 10

what are the symptoms of otitis media?

Answer 10

> hearing loss
speech delay
behavioural problems
academic decline

Question 11

what is the aetiology of otitis media with effusion?

Answer 11

> Eustachian tube dysfunction
adenoidal hypertrophy
resolving acute otitis media

Question 12

what can be used in children with otitis media with effusion?

Answer 12

> grommets
auto-inflation (blowing up a balloon with their nose)
hearing aides
adenoidectomy

Question 13

when would you perform an adenoidectomy?

Answer 13

in recurrent otitis media with effusion

Question 14

what are the symptoms for acute otitis media?

Answer 14

> short history
> pain
> fever
> systemic upset
> ear discharge

Question 15

what can cause acute otitis media?

Answer 15

> haemophilus influenza
strep pneumonia
Moraxella catarrhalis

Question 16

how would you manage acute otitis media?

Answer 16

> analgesia
antibiotics: amoxicillin/co-amoxiclav(erythromycin/clarithromycin 2nd line)
low dose long course for recurrent

Question 17

what are the extra-cranial complications of acute otitis media?

Answer 17

> acute mastoiditis/mastoid abscess
> facial nerve palsy
> ossicular damage
> labrynthitis
> chronic perforation

Question 18

what are the intracranial complications of acute otitis media?

Answer 18

> febrile convulsion
brain abscess
meningitis
sub/extradural empyema

Question 19

how would you manage recurrent/complicated acute otitis media?

Answer 19

grommet insertion +/- adenoidectomy

Question 20

what is normal time span for a child with a runny nose?

Answer 20

8 episodes a year that are up to 15 days

Question 21

what air sinuses develop in the first 4 months?

Answer 21

the ethmoids and maxillary

Question 22

what air sinuses develop from three to seven years?

Answer 22

the sphenoid sinuses

Question 23

what air sinuses develop by adolescence?

Answer 23

the frontal air sinuses

Question 24

what would you check in the history of a child with a runny nose?

Answer 24

> nasal symptoms: pain, discharge, loss of function
foreign body
feeding
quality of sleep

Question 25

how would you manage rhinitis?

Answer 25

> check whether it is allergic or not > IgE allergen test > nasal douching, antihistamines, nasal steroids

Question 26

what would yo check for in a child with large adenoids?

Answer 26

sleep apnoea

Question 27

why is a battery stuck up the nose (or in the ear) an emergency?

Answer 27

it can corrode through the tissue if not removed quickly

Question 28

what are sinusitis and polyps associated with?

Answer 28

cystic fibrosis

Question 29

what complications can arise from sinusitis and polyps?

Answer 29

> eye swelling due to pus compressing the eye socket

Question 30

what is choanal atresia?

Answer 30

congenital condition where the back of the nasal passage is blocked due to failed recanalization of nasal fossa in foetal development

Question 31

how would bilateral choanal atresia manifest?

Answer 31

as the inability to breath

Question 32

what is epistaxis?

Answer 32

nose bleed

Question 33

what should you consider with epistaxis?

Answer 33

> coagulopathy > haematological abnormality > digital trauma

Question 34

what area does the nose usually bleed from?

Answer 34

littles area

Question 35

what antibiotic ointment can you give for epistaxis?

Answer 35

> naseptin | > bactroban

Question 36

what cautery management can you provide for epistaxis?

Answer 36

> silver nitrate under local anaesthetic | > diathermy under general anaesthetic

Question 37

how can you manage epistaxis?

Answer 37

> first aid > antibiotic ointment > cautery management > nasal packing

Question 38

what would you want to check in a history of a patient with a sore throat?

Answer 38

> pain (odynophagia, ear ache) > discharge > loss of function > snoring, drooling

Question 39

what is a complication that can arise from tonsillitis that causes a collection of pus in the back of the throat?

Answer 39

quinsy

Question 40

what differences in a child's (compared to an adult) airway means that there can often be issues?

Answer 40

``` > large tongue > large tonsils > large epiglottis > short neck > sub glottis is narrowest ```

Question 41

is stridor inspiratory or expiratory?

Answer 41

inspiratory

Question 42

what conditions lead to airway issues in a child?

Answer 42

> foreign body > epiglottitis > laryngomalacia

Question 43

what may cause neck lumps?

Answer 43

> thyroglossal duct cyst > branchial cysts > cystic hygroma > cervical lymhadeopathy